Videos

Experts featured in this series.

The panel discusses the full multidisciplinary team required to optimize outcomes for patients with ROS1-positive advanced NSCLC: neuro-oncology for brain metastasis management, radiation oncology for CNS and bone disease, palliative care and symptom management specialists from diagnosis, physical therapy and nutrition, social work, and mental health services.

Experts featured in this series.

For the patient with a G2032R resistance mutation and intracranial progression, the panel unanimously favors lorlatinib-based therapy in second line based on its known activity against solvent-front mutations and documented CNS penetrance, with median duration of response of approximately 7 to 8 months in this setting.

Experts featured in this series.

The second clinical case presents a patient with ROS1 fusion-positive advanced NSCLC who achieved partial response on frontline lorlatinib, maintained for 18 months, before symptomatic and radiographic progression: increasing primary tumor size, new contralateral pulmonary nodules, and brain MRI showing 3 new small intracranial lesions.

Experts featured in this series.

All panelists select lorlatinib at 600 mg for this patient based on response rates, duration of disease control, favorable tolerability, and its design intent to achieve superior CNS penetration compared to earlier-generation ROS1 inhibitors, which is particularly relevant given the patient's age, symptomatic disease burden, and risk of future CNS progression.

Experts featured in this series.

Beyond efficacy, the panel identifies the key factors influencing agent selection: brain metastasis activity given the high prevalence of CNS involvement in younger ROS1-positive patients; toxicity profiles (earlier agents cause significant dizziness, taste changes, and neuropathic pain that are poorly tolerated chronically); frequency of clinic visits; and insurance access.

1 expert is featured in this series

Misako Nagasaka, MD, PhD, describes how it is a “great time to be a thoracic oncologist” with the constantly expanding armamentarium in the field. She specifically discusses the available treatment options in frontline EGFR mutation–positive advanced non–small cell lung cancer and what particular clinical and lifestyle benefits are provided by the treatment regimen of subcutaneous amivantamab plus lazertinib.

1 expert is featured in this series

Misako Nagasaka, MD, PhD, discusses practical considerations for oncologists implementing subcutaneous (SC) vs intravenous (IV) amivantamab plus lazertinib in the frontline setting for patients with EGFR-mutated advanced or metastatic non–small cell lung cancer. Nagasaka recommends the SC over the IV regimen in the frontline setting, particularly when focusing on convenience and patients’ quality of life.

1 expert is featured in this series

Misako Nagasaka, MD, PhD, discusses optimizing patient management when administering frontline SC amivantamab plus lazertinib in patients with EGFR-mutated advanced non–small cell lung cancer. She describes how the majority of adverse events (AEs) with the SC regimen in the PALOMA-2 trial occurred during first 4 months of treatment. According to Nagasaka, this highlights the importance of early patient counseling regarding expectations and reporting of AEs when starting the SC regimen.

1 expert is featured in this series

Misako Nagasaka, MD, PhD, describes the tolerability results with subcutaneous (SC) amivantamab plus lazertinib in patients with treatment-naïve, EGFR-mutated advanced non–small cell lung cancer from the PALOMA-2 trial. She explains that the data thus far have shown comparable discontinuation rates related to adverse events for the SC regimen compared with what has been observed with intravenous amivantamab regimens in prior studies.

1 expert is featured in this series

Misako Nagasaka, MD, PhD, discusses the overall response rate and duration of response with subcutaneous (SC) amivantamab plus lazertinib in patients with treatment-naïve, EGFR-mutated advanced non–small cell lung cancer, as reported from the PALOMA-2 trial. She explains the significance of the durability demonstrated by the SC regimen in the frontline setting for EGFR-mutated advanced NSCLC.